| Ste Genevieve County Memorial Hospital | |
|
590 Pine Dr Ste Genevieve MO 63670-1456 | |
| (573) 883-4455 | |
| (573) 883-4472 |
| Full Name | Ste Genevieve County Memorial Hospital |
|---|---|
| Speciality | Clinic/Center |
| Location | 590 Pine Dr, Ste Genevieve, Missouri |
| Authorized Official Name and Position | Amanda Wolk (BUSINESS OFFICE DIRECTOR) |
| Authorized Official Contact | 5738837703 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ste Genevieve County Memorial Hospital Po Box 366 Ste Genevieve MO 63670-0366 Ph: (573) 883-4455 | Ste Genevieve County Memorial Hospital 590 Pine Dr Ste Genevieve MO 63670-1456 Ph: (573) 883-4455 |
| NPI Number | 1730238551 |
|---|---|
| Provider Enumeration Date | 01/10/2007 |
| Last Update Date | 01/13/2023 |
| Medicare PECOS PAC ID | 3274432802 |
|---|---|
| Medicare Enrollment ID | O20040310001286 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730238551 | NPI | - | NPPES |
| 500142609 | Medicaid | MO | |
| CC8331 | Other | MO | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (Missouri) | Primary |
| Provider Name | Kevin T Enger |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1376607564 PECOS PAC ID: 3971401688 Enrollment ID: I20031219000342 |
| Provider Name | Dan H Frissell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407829849 PECOS PAC ID: 8022093780 Enrollment ID: I20040618000828 |
| Provider Name | Justin W Roberts |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1619057064 PECOS PAC ID: 9436101524 Enrollment ID: I20050217000090 |
| Provider Name | Matthew S Bosner |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1922088749 PECOS PAC ID: 8325082225 Enrollment ID: I20050613000213 |
| Provider Name | Gail L Craft |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043361264 PECOS PAC ID: 0749217032 Enrollment ID: I20050719000339 |
| Provider Name | Holly A Huelskamp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336229202 PECOS PAC ID: 7911922216 Enrollment ID: I20051005001202 |
| Provider Name | Chandra B Dommaraju |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1255361135 PECOS PAC ID: 7315963741 Enrollment ID: I20051017000191 |
| Provider Name | Susan M Odonnell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720051162 PECOS PAC ID: 3678675170 Enrollment ID: I20070302000014 |
| Provider Name | Casey L Stahlheber |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1497950265 PECOS PAC ID: 4486754900 Enrollment ID: I20070713000117 |
| Provider Name | Joann Uding |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518089564 PECOS PAC ID: 6002974979 Enrollment ID: I20081021000631 |
| Provider Name | Briccio S Cadiz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932182722 PECOS PAC ID: 2264598648 Enrollment ID: I20090310000449 |
| Provider Name | Mary E Crecelius |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841272861 PECOS PAC ID: 6406036508 Enrollment ID: I20110207000742 |
| Provider Name | Kelly A Donze |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1154636579 PECOS PAC ID: 4587833165 Enrollment ID: I20110816000838 |
| Provider Name | Naeem Aslam |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1750347902 PECOS PAC ID: 6002720349 Enrollment ID: I20120524000123 |
| Provider Name | Kimberly L Browne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710239496 PECOS PAC ID: 7618120684 Enrollment ID: I20121227000369 |
| Provider Name | Robin D Goff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639507957 PECOS PAC ID: 5597993105 Enrollment ID: I20140106000036 |
| Provider Name | Lacey E Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174951503 PECOS PAC ID: 5395973697 Enrollment ID: I20140113001307 |
| Provider Name | Regine E Politte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063813046 PECOS PAC ID: 2466673223 Enrollment ID: I20141020001092 |
| Provider Name | Anne K Wolk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639562028 PECOS PAC ID: 8820318785 Enrollment ID: I20150518001731 |
| Provider Name | Heather Jo Cheaney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225487143 PECOS PAC ID: 0143512590 Enrollment ID: I20160706000877 |
| Provider Name | Melissa A Naeger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538616362 PECOS PAC ID: 0042590424 Enrollment ID: I20161130001108 |
| Provider Name | Zaki H Chowdhury |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366456022 PECOS PAC ID: 1456345669 Enrollment ID: I20161216000111 |
| Provider Name | Christina Marie Peters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851767149 PECOS PAC ID: 5294042925 Enrollment ID: I20170815002537 |
| Provider Name | Lisa Engle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437668969 PECOS PAC ID: 2567738081 Enrollment ID: I20171026003395 |
| Provider Name | Erika Leung |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326453721 PECOS PAC ID: 0345542106 Enrollment ID: I20180710003037 |
| Provider Name | Samuel Mearl Medaris |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1720159346 PECOS PAC ID: 5092861435 Enrollment ID: I20200123002871 |
| Provider Name | Kelly R Grein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407455421 PECOS PAC ID: 2860803467 Enrollment ID: I20201203001991 |
| Provider Name | Morgan Ritter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316529951 PECOS PAC ID: 7517362320 Enrollment ID: I20210817002353 |
| Provider Name | Deniane John |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881256014 PECOS PAC ID: 4981933439 Enrollment ID: I20220929000876 |
| Provider Name | Stephanie R Moll |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588374698 PECOS PAC ID: 1658744313 Enrollment ID: I20230227002949 |
| Provider Name | Abigail Fischer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861146557 PECOS PAC ID: 1052772563 Enrollment ID: I20230801000749 |
| Provider Name | Sarah Mariah Peth Bohnert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245857036 PECOS PAC ID: 0446673503 Enrollment ID: I20230913002899 |
Ste Genevieve County Memorial Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 120 Plaza Dr, Ste Genevieve, MO 63670 Phone: 573-883-1199 Fax: 573-883-1189 | |
Ste Genevieve County Memorial Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 800 Ste Genevieve Dr, Ste Genevieve, MO 63670 Phone: 573-883-4473 Fax: 573-883-4472 | |
Ste Genevieve County Memorial Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 753 Pointe Basse Dr, Ste Genevieve, MO 63670 Phone: 573-883-2782 Fax: 573-883-3681 | |
Ste Genevieve County Memorial Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 753 Pointe Basse Dr, Ste Genevieve, MO 63670 Phone: 573-883-2782 |